Tasmina Ahmed-Sheikh: We need to look at the race disparity in maternal care

Shocking statistics show that black women are four times more likely to die in pregnancy and childbirth than white women, mixed heritage women three more times as likely, and Asian women two more times as likely. These are the kind of statistics that make you sit up and wonder what on earth has gone wrong. Why have we let down women from ethnic minority backgrounds so badly?

This particular petition was brought to parliament to examine the horrendous racial disparities in maternal care and discuss how to close this gap between black and white women’s experience of childbirth within the NHS. The data is sourced from the latest 2020 MBRRACE-UK report on the Confidential Enquiry into Maternal Deaths 2016-18 which highlights the number of maternities and associated deaths by ethnicity and makes for shocking reading. It is all the more appalling given the UK Government’s recent race report which tried to pretend that structural racism doesn’t exist. There’s a lot of that about at the moment, saying issues don’t exist when sections of society know that it is these very issues that they have to deal with every single day of their lives.

One way to combat disparities like this is to collect data and examine correlations. Only through gathering data and information on these women’s experiences can we understand the reasons behind this disparity and how we can help change this glaring inequality. Data in this context can inform important decision making and can be literally life-saving. And, importantly, data in this instance needs to record both sex and ethnicity in order to gain insight so as to close this gap.

It seems like an obvious thing to do. And yet so much of our world is designed around data that misses out whole sections of the population – namely women and communities of colour.

Feminist author, journalist and activist, Caroline Criado-Perez has been arguing for the importance of sex disaggregated data, ie data specific to women, for quite some years now to correct the skewing of data that ignores women’s lived experiences, and focuses instead on the default male view. Her research is backed up by those in the medical profession. In a blog in the British Medical Journal published last year, authors argued that sex-disaggregated data is in fact beneficial to both males and females. They used the Covid-19 pandemic as an example, whereby women compared favourably to men in terms of their immune response to the virus. They explained that the data showed how men were more adversely affected by Covid as compared to women and how this disparity could offer essential insights into treatment and vaccine development.

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In the same way that men seem to catch Covid more than women, their data showed that women are exposed to the virus more than men, because of their work environment for instance, with more women working in healthcare than men, or even because the initial PPE that arrived in hospitals at the start of the pandemic did not fit women as it had been made to measure to male sizes.

The blog went on to point out that it’s not just sex but also race and ethnicity that increases the risk of catching Covid, where once again data collection was essential “to ensure the intersection between race and sex is fully captured”.

In other words, the pandemic has highlighted how important it is to “insist upon the collection of sex-disaggregated data as standard” in order to ensure “better health outcomes for all, wider consideration of protection, exposures, management, treatment and clinical outcomes and consequences”.

Writers of the blog specified that they were using the term “sex” deliberately in terms of biology rather than “gender” which is sociological. To confuse these two terms would skew the results or indeed make them meaningless in terms of how Covid has impacted differently on women and men.

And yet, if you were to say this sentence out loud, you’d need to be prepared to welcome the wrath of an army of keyboard warriors, all because you believe sex-based rights matter and they should be maintained as a legal protection alongside the long list of protected characteristics as set out in the Equalities Act 2010.

In an atmosphere akin to Arthur Miller’s The Crucible, to argue for a balance of rights to ensure no one group’s rights impinge on another, or to protect women’s rights as recognised in law, is to welcome a tsunami of allegations and a trial in the court of public opinion and hysteria that shouts “guilty, guilty, guilty” – “I saw Goody Proctor, consorting with the gender critical feminists!”

But this is no flippant matter. There’s nothing funny or ironic or silly about any of this. One look at racial disparities in maternal care, or women’s different experience of side effects from drugs or warning signs of heart attacks, or the disparity between men and women in terms of immunity to Covid and the prevalence of illness from this virus in ethnic minority communities, shows us that this is indeed a very serious matter.

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It’s about life and death, it’s about rights and discrimination which affects women and men, ethnicities, minorities and the rainbow of genders. It’s about humanity. And ultimately, it’s about science and data, not feelings, or ideology or skewed statistics that ignore 51% of the population, sidelines biology or fails to take into account the colour of our skin and our lived experience.

Let’s talk about this with respect. Let’s ensure that we collect data on a scientific and measurable basis. And let’s use this data to change all our lives for the better.